Wk 10: Principles of cancer treatment Flashcards
What is systemic anticancer therapy?
- Cytotoxic chemotherapy
- Biological therapies
- Hormonal therapies
- Immunotherapy
What is chemotherapy?
Chemical toxic to multiplying cells
What does folfox contain?
- Oxaliplatin (alkylating agent): non cell cycle specific
- Fluorouracil (antimetabolite): cell cycle specific
What are cell cycle non-specific drugs?
- Kills cells at all phases inc. resting
- Given: large bolus dose on day 1
What are cell cycle specific drugs?
- Kills cell at specific point
- Given: more than once over several days/continuous infusion
What are the problems of chemotherapy?
- Relapse
- Resistance
What are the general principles of chemotherapy?
- Earlier = better
- Consider toxicity: frequent blood count + support
Which cancers have seen the most success when using chemotherapy?
- Childhood leukaemia
- Acute leukaemia in adults
- Testicular cancer
- Lymphoma
Define curative chemotherapy
Definitive treatment for cure (acute leukaemia)
Define adjuvant chemotherapy
- Given after surgery or radiotherapy
- Eradicate micrometastases
- Improve cure rate
Define neoadjuvant chemotherapy
- Given prior to treatment to facilitate procedure + improve cure chances
- Shrink large tumour = more operable
Define palliative chemotherapy
- Control symptoms + improve QoL
- Prolong life
Why is combination chemotherapy used over single agent?
- Different sites/MOA
- Non-overlapping toxicities
- Bigger destruction of cancer cells
- Inhibit resistance
What are the monitoring requirements needed when undergoing chemotherapy?
Response + toxicity
What can be used to measure response to treatment?
- Tumour markers
- Imaging
- Treatment intention
What is measured when reviewing toxicity?
- FBC
- U+E: renal + liver
- Symptoms
- Weight
When is hormone therapy used?
Hormone driven cancers
What does hormone therapy entail?
- Shrink tumour
- Slow/stop growth
- Red symptoms
- Makes cancer less likely to spread
- Red risk of breast cancer in at risk women
- Diff. treatment depending on menopause status
How does hormone therapy work?
- Red amount of hormone or antagonist at hormone receptor
- Given for longer periods
What is targeted therapy?
Targets change in cancer cells that help them grow, divide + metastasise
What is the mechanism of action of targeted therapy?
- Induce immune response
- Inhibit cancer cell growth
- Inhibit angiogenesis
- Release cytotoxic agent at site of action
- Induce apoptosis
- Inhibit hormone dependent growth
What are the advantages of targeted therapy?
More precise + fewer s/e
What are the types of targeted therapy?
- Monoclonal antibody eg. cetuximab
- Small molecule eg. sunitinib
Monoclonal antibodies (targeted therapy)
- Block receptor on surface of cancer cell
- Activate WBC
- Manufactured using living cells
- Some deliver chemo to cancer cells
- IV every 1-3 wks
Small molecule (targeted therapy)
- Less specific
- Block kinase (tyrosine kinase inhibitor)
- Orally every day
What is immunotherapy?
Treatment that works via immune system
What are the 3 main groups of immunotherapy?
- Monoclonal antibodies
- Checkpoint inhibitors
- CAR T cell therapy
What is radiotherapy?
- Uses high energy rays (x-rays)
- Destroys cancer cells in area given but also healthy cells
What are the types of radiotherapy?
- External beam: radiotherapy machine to aim beams at cancer
- Internal beam: radioactive liquid
What is surgery used for?
- Diagnose
- Remove cancer
- How big + spread of cancer
- Symptom control
- Restore body parts
- Improve appearance of body
